Transduction and mutation to glycine tolerance in vibrio fetus.
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Abortion, Veterinary↗
Biomedical subjects
W Chang
Publications and source records attributed to W Chang.
Transduction in vibrio fetus.
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Abortion, Veterinary↗
WHO respiratory disease survey in children: a serological study.
This paper is a report on the first (serological) phase of a study organized by WHO in collaboration with the WHO International Reference Centre for Respiratory Virus Diseases other than Influenza in Bethesda, Md., USA, to define the viral etiology of severe respiratory infections in children, particularly in tropical areas. Paired sera from 528 children up to 5 years old admitted to hospital with severe respiratory illness of probable viral etiology were collected in 10 countries and sent frozen to the International Reference Centre, where standard complement-fixation tests were made for the following agents: parainfluenza virus types 1, 2 and 3, influenza virus types A and B, adenoviruses, respiratory syncytial virus, Mycoplasma pneumoniae, Coxiella burneti and psittacosis-ornithosis.Some 41% of paired sera showed rising antibody titres for one or more of these agents, multiple infections being observed in 8%. In most of the countries the pattern of infection was similar. RS virus was the most important respiratory tract pathogen of early life, particularly in the first year of life and in cases of bronchiolitis and pneumonia; the parainfluenza viruses were next in importance, particularly in cases of croup, but, in contra-distinction to RS virus infections, they were commoner in older children. Influenza, adenoviruses, and M. pneumoniae were of moderate importance, and C. burneti and the psittacosis-ornithosis agents were relatively rare. This pattern is similar to that which has been observed in temperate climates.
Africa↗
Cholinesterase in hepatobiliary diseases.
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Biliary Tract Diseases↗
Transscleral choroidal biopsy in the diagnosis of choroidal lymphoma.
A 57-year-old man with non-Hodgkin's B-cell lymphoma of the abdominal lymph nodes developed moderate cells in the anterior chamber and vitreous, choroidal infiltration, and total nonrhegmatogenous retinal detachment in both eyes while receiving chemotherapy. After a diagnostic vitrectomy in the left eye was nonrevealing, the patient was referred to the oncology service. Fine-needle aspiration biopsy of the choroidal infiltrate was not done because of poor visualization of the choroid through the turbid subretinal fluid. Transscleral choroidal biopsy was performed without complications and disclosed diffuse high-grade B-cell lymphoma and no signs of endogenous infection. Transscleral choroidal biopsy is a useful technique in eyes with choroidal infiltration, especially when hazy media prohibit fine needle biopsy.
Biopsy, Needle↗
Nonthyroid causes of extraocular muscle disease.
Extraocular muscle involvement in orbital disease is most frequently seen as a feature of thyroid orbitopathy (Graves' disease). However, a wide range of other conditions may alter the size, shape, and function of these muscles, with characteristic clinical manifestations or abnormalities visible on orbital imaging. The differential diagnosis of muscle disease can be narrowed by careful analysis of clinical features and ancillary tests. Imaging facilitates recognition in many cases, but in some instances, accurate diagnosis requires biopsy. This review highlights the differential diagnoses for diseases of extraocular muscles based on the clinical and investigative records of 103 patients at our institution combined with data from the world literature. We found that the most common nonthyroid causes of muscle disease were inflammatory, vascular, and neoplastic processes (in decreasing order of frequency). Emphasis is placed on investigations that provide a logical approach to, and appropriate management of, disease of the extraocular muscles.
Amyloidosis↗
Slice characteristics of the Imatron Cine-CT scanner.
Unlike conventional CT, the Imatron Cine-CT uses an extended and fixed target ring in generating a fast scanning X-ray. Multiple slice capability to cover an imaging volume is facilitated by multiple targets and detector rings. For technical reasons, the plane of the target ring must be offset slightly with respect to the detector plane. This report examines the slice characteristics in the imaging volume and the effect of this plane-offset feature. Implications for clinical imaging are discussed.
Cineradiography↗
Reduced MR acquisition time with the CROCUS technique.
A technique to reduce magnetic resonance (MR) image acquisition time by approximately 50% is introduced. The conjugate reconstruction by off-center under-sampling (CROCUS) method samples only every other phase-encoded line in raw data space and uses the conjugate symmetry of the data to reconstruct a real image. If acquisition and image reconstruction were done in the simplest manner, this under-sampling would produce unacceptable image aliasing. However, if the phase-encoded lines are offset from the origin, the assumption of conjugate symmetry allows the image to be calculated without aliasing. Unfortunately, information from all practical MR systems contain phase-shift errors that produce deviations from conjugate symmetry. The CROCUS method incorporates a correction technique, similar to that used in other half-Fourier methods, which uses low-resolution phase-shift information obtained from a few extra lines of phase-encoded data. This paper provides a theoretical derivation of the reconstruction algorithm and correction technique and illustrates the results. Excellent image quality is obtained with no loss of spatial resolution. Image signal-to-noise ratio is reduced by a factor of approximately 1.4 because of the reduced acquisition time. When the imaging circumstances are such that a high signal level is available, CROCUS imaging can be an effective means of reducing imaging time.
Humans↗
Organizational and employee predictors of outcomes of long-stay nursing home residents.
OBJECTIVE: Use three types of functional ability as predictors of nursing home patient outcomes. DESIGN: Best-subsets regression analysis. SETTING: 10 nursing homes. RESULTS: Initial functional ability was the most important predictor. Organizational variables such as workload, stress, and morale also explained some of the variance in patient outcomes. Characteristics of organizational structure predicted outcomes as well as employee self-reports and could be substituted for them without substantially reducing the explained variance. CONCLUSION: Future research projects should explore the causal relationship between structure and outcomes.
Activities of Daily Living↗
Is obesity a favorable prognostic factor in peritoneal dialysis patients?
OBJECTIVE: To determine the influence of an elevated body mass index (BMI) on cardiovascular outcomes and survival in peritoneal dialysis (PD) patients. DESIGN: Prospective, observational study of a prevalent PD cohort at a single center. SETTING: Tertiary care institutional dialysis center. PATIENTS: The study included all patients with a BMI of at least 20 who had been receiving PD for at least 1 month as of 31 January 1996 (n = 43). Patients were classified as overweight [BMI > 27.5; mean +/- standard error of mean (SEM): 32.1 +/- 1.1; n = 14] or normal weight (BMI 20-27.5; mean +/- SEM: 23.8 +/- 0.4; n = 29). OUTCOME MEASURES: Patient survival and adverse cardiovascular events (myocardial infarction, congestive cardiac failure, cerebrovascular accident, and symptomatic peripheral vascular disease) were recorded over a 3-year period. RESULTS: At baseline, no significant differences were seen between the groups in clinical, biochemical, nutritional, or echocardiographic parameters, except for a lower dietary protein intake (0.97 +/- 0.10 g/kg/day vs 1.44 +/- 0.10 g/kg/day, p = 0.004) and a higher proportion of well-nourished patients by subjective global assessment (100% vs 72%, p < 0.05) in the overweight group. After 3 years of follow-up, 29% of overweight patients and 69% of normal-weight patients had died (p < 0.05). Using a Cox proportional hazards model, a BMI greater than 27.5 was shown to be an independent positive predictor of patient survival, with an adjusted hazard ratio (HR) of 0.09 [95% confidence interval (CI): 0.01-0.85; p < 0.05]. However, being overweight did not significantly influence myocardial infarction-free survival (adjusted HR: 0.33; 95% CI: 0.07-1.48; p = 0.15) or combined adverse cardiovascular event-free survival (adjusted HR: 0.67; 95% CI: 0.23-1.93; p = 0.46). CONCLUSIONS: Obesity conferred a significant survival advantage in our PD population. Obese patients should therefore not be discouraged from receiving PD purely on the basis of BMI. Moreover, maintaining a higher-than-average BMI to preserve "nutritional reserve" may help to reduce the mortality and morbidity rates associated with PD.
Aged↗
Serum leptin correlates with fat mass but not dietary energy intake in continuous ambulatory peritoneal dialysis patients.
OBJECTIVES: In view of previous studies demonstrating hyperleptinemia in uremic and hemodialysis patients, the aims of the present study were to determine whether serum leptin levels are elevated in peritoneal dialysis (PD) patients, to establish whether leptin is significantly removed by PD, and to elucidate the relationship of plasma leptin to body composition, dietary intake, nutritional indices, and dialysis adequacy. DESIGN: Cross-sectional analysis of PD patients and matched healthy controls. SETTING: Tertiary-care institutional dialysis center. PARTICIPANTS: The study included 49 PD patients [35 women and 14 men; median age 63 years, interquartile range (IQR) 49.5-68.5 yr; body mass index (BMI) 25.5 +/- 0.8] and 27 controls (11 men and 16 women; median age 42 years, IQR 34.8-51; BMI 27.2 +/- 0.9). For evaluation of leptin clearance, 8 patients receiving nocturnal intermittent PD were also evaluated. MAIN OUTCOME MEASURES: The primary outcome measure was plasma leptin concentration. Dialysate leptin concentration was also measured in 7 patients. RESULTS: Serum leptin levels were significantly higher (p < 0.01) in patients (males: median 11 ng/mL, IQR 9-19 ng/mL; females: 53 ng/mL, 19.5-128 ng/mL) compared with controls (males: 5.5 ng/mL, 4-9.5 ng/mL; females: 12 ng/mL, 9.8-17.3 ng/mL). Leptin levels in both groups correlated positively with BMI (r = 0.64 and 0.60, respectively; p < 0.0001) and with percentage body fat determined by dual-energy x-ray absorptiometry (r = 0.86 and 0.82, respectively; p < 0.01). Dialysis patients exhibited a greater increase in serum leptin for any given increase in BMI. No significant correlation was observed between leptin concentration and residual renal function, dialysis adequacy (Kt/V), dietary protein or caloric intake, or serum levels of albumin, prealbumin, C-reactive protein, glucose, and insulin-like growth factor-I. Although leptin was detectable in peritoneal dialysate after a 6-hour dwell (median 4.2 ng/mL, IQR 1.1-8.5 ng/mL, n = 8), serum leptin levels were not appreciably lowered following intermittent PD via an automated cycler (63.9 +/- 19.3 ng/mL vs 57.6 +/- 20.5 ng/mL, p = NS, n = 8). CONCLUSIONS: Serum leptin levels are elevated in PD patients and are not appreciably cleared by PD. Although hyperleptinemia correlates poorly with dialysis adequacy and protein intake, a strong and significant relationship was maintained between serum leptin and fat mass. Serum leptin could therefore serve as a useful clinical marker of body fat content in PD patients.
Adipose Tissue↗